Morbilidad y mortalidad de la duodenopancreatectomía cefálica convencional en pacientes con enfermedad del confluente biliopancreático

Introducción: La duodenopancreatectomía cefálica es una operación cada vez más frecuente en pacientes seleccionados. Objetivo: Identificar la morbilidad y la mortalidad concerniente a la duodenopancreatectomía cefálica convencional. Métodos: Se realizó un estudio observacional, descriptivo de una serie de 15 casos operados de duodenopancreatectomía cefálica. Se investigaron las variables: estadificación según clasificación tumor, linfonódulo, metástasis (TNM), diagnóstico anatomopatológico, complicaciones, tiempo quirúrgico y estado al egreso. Se utilizaron el número absoluto y el porcentaje como medidas de resumen para las variables estadificación y diagnóstico; la media, la mediana y el rango para el tiempo quirúrgico y el intervalo de confianza para el estado al egreso. Resultados: El diagnóstico anatomopatológico principal fue adenocarcinoma de páncreas con 9 pacientes (60,1 %) y de duodeno con 2 (13,3 %). El estadio posoperatorio IIA fue el que prevaleció con 5 (45,5 %). El retraso del vaciamiento gástrico fue la complicación quirúrgica que prevaleció, con 7 (46,7 %) enfermos, seguida de la fístula biliar con 3 (20,0 %). La fístula pancreática, la lesión de la vena mesentérica superior y la hemorragia posoperatoria se presentaron una sola vez (6,7 %), respectivamente. Estas 2 últimas, provocaron la muerte del enfermo en las primeras 48 horas del posoperatorio. Fallecieron 4 (26,7 %) pacientes de la serie. Conclusiones: Las complicaciones posquirúrgicas se observan principalmente a expensas del retardo del vaciamiento gástrico, la fístula biliar y pancreática. La mortalidad puede estar relacionada con la prolongación del tiempo quirúrgico igual o mayor de 5 horas, con el consiguiente aumento de las pérdidas hemáticas.

Introduction: Cephalic duodenopancreatectomy is an increasingly frequent operation in selected patients. Objective: To identify the morbidity and mortality related to conventional cephalic duodenopancreatectomy. Methods: An observational, descriptive study of a series of 15 cases operated on cephalic duodenopancreatectomy. The variables were investigated: staging according to the Tumor, Linphonod, Metastasis (TNM) classification, pathological diagnosis, complications, surgical time and discharge status. Absolute number and percentage were used as summary measures for the variables staging and diagnosis; mean, median and range for surgical time and confidence interval for discharge status. Results: The main pathological diagnosis was adenocarcinoma of the pancreas with 9 patients (60.1%) and of the duodenum with 2 (13.3%). Postoperative stage IIA was the one that prevailed with 5 (45.5%) patients. Delayed gastric emptying was the prevailing surgical complication, with 7 (46.7%) patients, followed by biliary fistula with 3 (20.0%). Pancreatic fistula, superior mesenteric vein injury, and postoperative hemorrhage occurred only once (6.7%), respectively. These last 2, caused the death of the patient in the first 48 hours of the postoperative period. Four (26.7%) patients in the series died. Conclusions: Postoperative complications are mainly observed at the expense of delayed gastric emptying and biliary and pancreatic fistula. Mortality may be related to the prolongation of surgical time equal to or greater than 5 hours with the consequent increase of blood loss.

"Houxi (SI 3) communicating the governor vessel" verified with the infrared thermal imaging technology / 中国针灸

OBJECTIVE@#To compare the effect on facial acupoint temperature between acupuncture at Houxi (SI 3) and Dazhui (GV 14) so as to verify "Houxi (SI 3) communicating the governor vessel" based on the infrared thermal imaging technology.@*METHODS@#Thirty-five healthy subjects (5 cases dropped off) were collected and before-after study in the same subject was adopted. The subjects were successively assigned into a sham-acupuncture group, a Houxi group, a Wangu group and a Dazhui group. Sham-acupuncture at Houxi (SI 3) on the left, acupuncture at Houxi (SI 3) on the left, Wangu (SI 4) on the left and Dazhui (GV 14) were given respectively. One intervention was given and the needles were retained for 30 min in each group. 30 min before and after acupuncture, the infrared thermal images of the face were collected, and the facial temperature was compared among the following 5 acupoints, i.e. Yintang (GV 24+), Suliao (GV 25), Shuigou (GV 26), Duiduan (GV 27) and Chengjiang (CV 24).@*RESULTS@#After acupuncture, the facial temperature at Yintang (GV 24+) and Chengjiang (CV 24) was increased compared before acupuncture in the sham-acupuncture group (P<0.01, P<0.05). The facial temperature at Suliao (GV 25) in the Houxi group was reduced after acupuncture (P<0.05). In the Wangu group, the temperature at Yintang (GV 24+) was increased compared before acupuncture (P<0.01). The facial temperature was increased at Duiduan (GV 27) and Chengjiang (CV 24) compared before acupuncture in the Dazhui group (P<0.01, P<0.05). The differences of facial temperature at Chengjiang (CV 24) and Suliao (GV 25) after acupuncture were larger than before acupuncture in the Houxi group and the Dazhui group (P<0.01). In comparison with the temperature at Suliao (GV 25) of the same group, the differences of facial temperature before and after acupuncture at Yintang (GV 24+), Shuigou (GV 26), Duiduan (GV 27) and Chengjiang (CV 24) were increased in the Houxi group (P<0.01, P<0.05); while, the increase was also obtained at Yintang (GV 24+), Shuigou (GV 26), Duiduan (GV 27) and Chengjiang (CV 24) in the Dazhui group (P<0.05, P<0.01). The difference of facial temperature at Yintang (GV 24+) before and after acupuncture was increased compared with Suliao (GV 25) in the Wangu group (P<0.05).@*CONCLUSION@#Acupuncture at Houxi (SI 3) generates a similar thermal effect as Dazhui (GV 14). It regulates and dissipates the core temperature to "govern the yang qi of the whole body".

Regulating effects of Neiguan(PC6)and Gongsun(SP4)on hypothalamic-pituitary-adrenal axis in rats with functional dyspepsia / 针灸推拿医学（英文版）

Objective:To investigate the effects and the possible mechanisms of Neiguan(PC6)and Gongsun(SP4)on the hypothalamic-pituitary-adrenal(HPA)axis in rats with functional dyspepsia(FD),thus to provide a theoretical basis for the clinical application of the Eight Confluent Points.Methods:Forty specific-pathogen-free Sprague-Dawley rats were divided into a blank group,a model group,an electroacupuncture(EA)group,and a Western medicine group by the random number table method,with 10 rats in each group.Rats in the blank group did not receive modeling or intervention.Rats in the other three groups were subjected to the FD with mood disorder model using the compound etiology modeling method.After the successful modeling,rats in the model group did not receive any interventions,rats in the Western medicine group received deanxit and mosaprid intervention,and those in the EA group received EA intervention on the ipsilateral Neiguan(PC6)and Gongsun(SP4)for 21 d.The sugar-water consumption rate was measured before the experiment and before and after interventions to assess the emotional status.The gastric emptying rate was measured after interventions to assess the gastrointestinal dynamics.The expression levels of hypothalamic corticotropin-releasing hormone(CRH),pituitary adrenocorticotropic hormone(ACTH),and adrenal corticosterone(CORT)were measured by enzyme-linked immunosorbent assay.Results:Compared with the blank group,the sugar-water consumption rate and the gastric emptying rate were decreased(P<0.01),and the hypothalamic CRH,pituitary ACTH,and adrenal CORT expression levels were increased(P<0.01)in the model group.Compared with the model group,the sugar-water consumption rate and the gastric emptying rate were significantly increased(P<0.01),while the expression levels of hypothalamic CRH,pituitary ACTH,and adrenal CORT were significantly decreased(P<0.01)in the EA group and the Western medicine group.The differences between the EA group and the Western medicine group were not statistically significant(P>0.05).Conclusion:The Eight Confluent Points Neiguan(PC6)and Gongsun(SP4)can improve the mood and gastrointestinal dynamics in FD rats,which may be achieved by down-regulating the hypothalamic CRH,pituitary ACTH,and adrenal CORT,as well as by correcting the HPA axis hyperfunction.

Caracterización clinicoepidemiológica de pacientes operados de duodenopancreatectomía cefálica con enfermedad del confluente biliopancreático / Clinical epidemiological characterization of patients operated on cephalic pancreaticoduodenectomy with disease of the biliopancreatic confluent

Introducción: La duodenopancreatectomía cefálica continúa siendo una intervención quirúrgica compleja. Objetivo: Caracterizar a los pacientes operados de duodenopancreatectomía cefálica según variables epidemiológicas, clínicas e histológicas seleccionadas. Métodos: Se realizó un estudio observacional, descriptivo y retrospectivo de una serie de 15 casos operados de duodenopancreatectomía cefálica en el Servicio de Cirugía General del Hospital Provincial Docente Saturnino Lora de Santiago de Cuba, durante el quinquenio 2016-2020. Las variables analizadas fueron edad, sexo, comorbilidades, hábitos tóxicos, síntomas y signos, así como tipo histológico de las lesiones. Resultados: Predominaron los pacientes del sexo masculino (80,0 %) y el grupo de 50 a 55 años de edad (40,0 %). Las comorbilidades más frecuentes fueron la hipertensión arterial en 80,0 % de la casuística, seguida de la diabetes mellitus en 53,3 %. Prevalecieron el tabaquismo (66,7 %) y el alcoholismo (60,0 %), así como los signos de obstrucción biliar (73,3 %). El diagnóstico histológico principal fue adenocarcinoma de páncreas en 60,1 % de los afectados. Conclusiones: La duodenopancreatectomía cefálica se realiza predominantemente en pacientes con adenocarcinomas de páncreas y, en menor medida, con adenocarcinomas de duodeno y otras afecciones benignas; en afectados del sexo masculino, con edades intermedias y avanzadas de la vida, hipertensión arterial y diabetes mellitus, así como tiempo prolongado de ser fumadores y consumidores de alcohol. Los signos de obstrucción biliar son de importancia capital en el diagnóstico clínico.

Introduction: The cephalic pancreaticoduodenectomy continues being a complex surgical intervention. Objective: To characterize patients operated on cephalic duodenopancreatectomy according to selected epidemiological, clinical and histologic variables. Methods: An observational, descriptive and retrospective study of a series of 15 cases operated on cephalic pancreaticoduodenectomy was carried out in the General Surgery Service of Saturnino Lora Teaching Provincial Hospital in Santiago de Cuba, during the five year period 2016-2020. The analyzed variables were age, sex, comorbidities, toxic habits, symptoms and signs, as well as histologic type of the lesions. Results: There was a prevalence of the male sex patients (80.0 %) and the 50 to 55 age group (40.0 %). The most frequent comorbidities were hypertension in 80.0 % of the case material, followed by the diabetes mellitus in 53.3 %. Nicotine addiction (66.7 %) and alcoholism (60.0 %) prevailed, as well as the signs of biliary obstruction (73.3 %). The main histologic diagnosis was pancreas adenocarcinoma in 60.1 % of those affected. Conclusions: The cephalic pancreaticoduodenectomy is carried out predominantly in patients with pancreas adenocarcinomas and, to a lesser extent, in patients with duodenum adenocarcinomas and other benign affections; in those affected of the male sex, with intermediate and advanced ages of life, hypertension and diabetes mellitus, as well as long time of being smokers and alcohol consumers. The signs of biliary obstruction are of capital importance in the clinical diagnosis.

Papilomatosis confluente y reticulada de Gougerot-Carteaud / Confluent and reticulated papillomatosis of Gougerot-Carteaud

La papilomatosis confluente y reticulada es una dermatosis infrecuente, benigna, de curso crónico y etiopatogenia desconocida. Actualmente, se acepta que se debe a un trastorno de la queratinización. Se caracteriza por máculas y pápulas hiperpigmentadas, que coalescen en el centro y adoptan un patrón reticular en la periferia. Se la puede confundir con otras patologías, como la pitiriasis versicolor y la acantosis nigricans. Con la administración de minociclina por vía oral suelen obtenerse excelentes resultados. Se comunica el caso de un paciente con diagnóstico de papilomatosis confluente y reticulada. Se describen sus características clínicas, criterios diagnósticos y trata-miento instaurado.

Confluent and reticulated papillomatosis is an infrequent, benign dermatosis of chronic course and unknown etiopathogenesis. Currently it is accepted that this dermatosis is due to a keratinization disorder. It is characterized by hyperpigmented macules and papules that coalesce in the center and adopt a reticular pattern in the periphery. It can be confused with other pathologies such as pityriasis versicolor and acanthosis nigricans. Oral minocycline usually shows excellent results. The present work reports a case of a patient with a diagnosis of confluent and retic-ulated papillomatosis, describing its clinical characteristics, diagnostic criteria and established treatment.

Histopathological Features and Clinical Variants of Biopsy Confirmed Psoriasis Cases in a Tertiary Care Setting in Kerala.

Psoriasis is a chronic, immune mediated, relapsing, papulosquamous disease having a high prevalence. Since it affects other organ systems such as musculoskeletal system, gastrointestinal system and the eye, it can lead to considerable disability. Although only rarely life threatening, it has high morbidity due to its chronicity and absence of cure. MethodsThis study was conducted over a period of 2 years in the Department of Pathology, Medical College, Thiruvananthapuram. A total of 217 skin biopsy specimens in which a clinical diagnosis / differential diagnosis of psoriasis was made, was studied during this period. Results108 cases out of 217 which were histopathologically diagnosed as psoriasis were studied in detail. Male predominance was noted in the study population. The mean duration of disease in this study was 6.69 yrs. Fifty percentage of the patients had associated comorbidities with hypertension outnumbering others. Among male patients, 26 (32.5 %) had the habit of smoking. The most common presentation was as erythematous scaly plaques, with pruritus being the second most common presentation. Histopathology proved to be conclusive of psoriasis in all cases. Hyperkeratosis was seen in all cases which was the most consistent histopathological feature. Confluent parakeratosis which is one of the characteristic features of psoriasis was seen in 62 (57.4 %) cases with the rest being focal. Other epidermal features studied were papillomatosis, hypogranulosis, suprapapillary thinning, and basal mitotic figures. Spongiosis was seen in 83 (76.9 %), exocytosis of neutrophils in 66 (61.1 %) and Munro’s micro abscess in 42 (38 %) cases. Dilated blood vessel was the most common dermal change observed, seen in 105 (97 %). Lymphocytes were the most frequent upper dermal inflammatory infiltrate observed. Oedema was seen in 5 (4.6 %) of cases. ConclusionsPsoriasiform lesions pose diagnostic dilemma to the treating clinician. To provide a clear-cut diagnosis, histopathological evaluation is essential. It is also important to differentiate between the different variants of psoriasis in the context of treatment. It has an important role in the follow up of psoriatic patients.

Clinical observation of acupuncture at Qianlianquan (Extra) and eight confluent points on chronic pharyngitis / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect of acupuncture at Qianlianquan (Extra) and eight confluent points on chronic pharyngitis.@*METHODS@#A total of 42 patients with chronic pharyngitis were randomized into an observation group and a control group, 21 cases in each one. In the observation group, acupuncture was applied at Qianlianquan (Extra) and eight confluent points [Neiguan (PC 6), Waiguan (TE 5), Lieque (LU 7), Houxi (SI 3), Gongsun (SP 4), Shenmai (BL 62), Zhaohai (KI 6) and Zulinqi (GB 41)], once a day, 6 days as one course, with an interval of 1 day between the courses, 4-course treatment was required. In the control group, granules were taken orally 5 g each time, 3 times a day, 7 days as one course and 4 courses were required. Before and after treatment, symptoms and signs scores of chronic pharyngitis and the contents of IL-2 and TNF-a in serum were compared in the two groups.@*RESULTS@#Compared before treatment, symptoms and signs scores of chronic pharyngitis and the contents of IL-2 and TNF-a in serum were improved in both groups (all <0.05), and the changes in the observation group were superior to the control group (all <0.05). The total effective rate was 90.5% (19/21) in the observation group, which was superior to 81.0% (17/21) in the control group (<0.05).@*CONCLUSION@#The therapeutic effect of acupuncture at Qianlianquan (Extra) and eight confluent points on chronic pharyngitis is superior to conventional Chinese patent medication treatment by granules.

Study of the thermal pain threshold latency of acupoints based on Fei Teng Ba Fa / 针灸推拿医学（英文版）

Objective:By applying moxibustion to the eight confluent points in different periods of time,to observe the changes in thermal pain threshold latency of acupoints based on Fei Teng Ba Fa.Methods:A total of 468 healthy college student volunteers received moxibustion at the eight confluent points in three different periods of time,i.e.Chen (7:00-9:00),Wu (11:00-13:00) and Xu (19:00-21:00).The thermal pain threshold latency was adopted to measure the changes in pain threshold of the eight confluent points under different conditions (different periods of time,different genders,different acupoints and different states of the acupoints) based on Fei Teng Ba Fa.Results:Finally,thirty subjects dropped out and 438 subjects were included.The comparison of thermal pain threshold latencies of the eight confluent points in the same opening or closing state based on Fei Teng Ba Fa:latencies of the closing points and adjunct points were significantly different in different periods of time (P＜0.05);the latencies of the males were significantly longer than those of the females (P＜0.05);there was no significant difference in the latency between the left and right sides (P＞0.05);in the female group,there was a significant difference in the latency between the lower-limb points and the upper-limb points (P＜0.05).The comparison of thermal point threshold latencies of the eight confluent points in different opening or closing state:in the period of Wu (11:00-13:00),the latencies of the opening points were significantly longer than those of the closing points and adjunct points (P＜0.05);for men,their opening and closing points had significantly longer thermal pain threshold latencies than their adjunct points (P＜0.05);despite the gender,the latencies of the upper limb opening and closing points were significantly longer than the latency of the adjunct points (P＜0.05);in the female group,the latencies of the lower-limb opening points were significantly shorter than those of the lower-limb closing and adjunct points (P＜0.05).Conclusion:Based on Fei Teng Ba Fa,the pain thresholds of the eight confluent points vary in different periods of time,gender,acupoint location and opening/closing state,which can be taken as the evidence of making time-based acupuncture-moxibustion prescriptions.

Clinical and Histopathologic Study of Confluent and Reticulated Papillomatosis by Anatomic Site and Age

BACKGROUND: Confluent and reticulated papillomatosis (CRP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. Few studies regarding this have been reported in the literature. OBJECTIVE: The purpose of this study was to investigate the clinical and histologic characteristics of CRP in Korean patients according to anatomic site and age. METHODS: We retrospectively reviewed the medical records, clinical photographs, and 40 histopathologic slides of 29 patients diagnosed with CRP. RESULTS: Sixteen adults and 13 adolescents were included. The predominantly involved anatomic sites were the trunk (89.7%) and axillae (27.6%); flexural area involvement was mainly found in the adolescent group. The mean disease duration was 2.3 times longer in the adult group than in the adolescent group. The histopathologic features included hyperkeratosis (95.0%), acanthosis (87.5%), and papillomatosis (77.5%) in the epidermis. In the adult group, only 10 specimens (52.6%) showed mild to moderate papillomatosis. There was no relationship between the histologic findings and disease duration; however, the former was associated with the anatomic site. CONCLUSION: The present study is the first to present the clinical and histologic features of CRP according to age and anatomic site in Korean patients. The patients in this study more frequently had fungal infections (31%) than patients in a previous study (12.8%). Histologic changes were more prominent in the adolescent group than in the adult group and in the flexural area than in the non-flexural area.

Confluent and Reticulated Papillomatosis Limited to the Forearm / 대한피부과학회지

No abstract available.

Abdominal acupuncture plus the Confluent Points of the Eight Extraordinary Meridian for chronic pharyngitis / 针灸推拿医学（英文版）

Objective:To evaluate the effectiveness of abdominal acupuncture plus the Confluent Points of the Eight Extraordinary Meridian in treating chronic pharyngitis. Methods:Thirty eligible subjects with chronic pharyngitis were given abdominal acupuncture plus needling Lieque (LU 7) and Zhaohai (KI 6), two out of the Confluent Points of the Eight Extraordinary Meridian, once a day, 10 sessions as a course, and the therapeutic efficacy was evaluated after a treatment course. Results:After a treatment course, of the 30 subjects, 21 were recovered, 5 showed markedly effective, 2 were improved, and 2 failed,the total effective rate was 93.3%. Conclusion:Abdominal acupuncture plus the Confluent Points of the Eight Extraordinary Meridian is effective in treating chronic pharyngitis, worth promoting in clinic.

"Analysis on Neiguan in""Great Compendium of Acupuncture and Moxibustion""" / 浙江中医药大学学报

[Objective] By means of study of related literature records about Neiguan points in Great Compendium of Acupuncture and Moxibustion, it is intended to provide a theoretical foundation for the application of Neiguan points in modern clinical acupuncture and moxibustion. [Method] Collect articles with regard to Neiguan points inGreat Compendium of Acupuncture and Moxibustion , and systematically analyze its location, needling and moxibustion techniques, as well as clinical application law. To investigate the clinical application of differences between ancient and modern Neiguan. [Results] InGreat Compendium of Acupuncture and Moxibustion, Neiguan points are located at 2-inch above palm strips. Needle can be penetrated into 3/10 inch, 1/2 inch, and 1.2inch between two tendons. Neiguan point is a collateral-connecting acupoint for pericardium meridian, and mainly treats cardiothoracic excess and deficiency related diseases. If matching with yangchi point, it can be called Yuan-primary point and collateral-connecting point combination that can treat triple energizer meridian related diseases. The Neiguan point is also regarded as the eight confluence point connecting Yinwei meridian that can treat mental diseases, Yinwei vessel is associated three yin meridians of foot diseases, conception vessel diseases and Yangming Channel penetration diseases. [Conclusion] It is concluded the location, needling therapy and clinical application law of Neiguan points in Great Compendium of Acupuncture and Moxibustion, which is of reference significance to the application of Neiguan points in modern clinical acupuncture and moxibustion.

A Case of Confluent and Reticulated Papillomatosis Treated with Oral Isotretinoin / 대한피부과학회지

No abstract available.

Study on the Influence of Needling the Eight Confluent Points plus Huo Xue Rong Luo Granules on GABA and Gly in ;Patients with Spastic Paralysis After Cerebral Infarction / 上海针灸杂志

Objective To observe the influence of needling the Eight Confluent Points plus Huo Xue Rong Luo granules on the levels of gamma-aminobutyric acid (GABA) and glycine (Gly) in patients with spastic paralysis after cerebral infarction. Method Sixty patients with spastic paralysis after cerebral infarction were randomized into a treatment group and a control group, 3 0 cases each. The control group was intervened by basic treatment, while the treatment group was by Huo Xue Rong Luo granules plus acupuncture at the Eight Confluent Points in addition to the basic treatment, for 6 treatment courses in total. Before the treatment, and after half-a-month, 1-month, and 3-month treatments, the Chinese Stroke Scale (CSS) and activities of daily living (ADL) were evaluated, the levels of GABA and Gly were detected by using high performance liquid chromatography (HPLC), and the therapeutic efficacies were compared. Result After half-a-month treatment, the CSS score dropped significantly in both groups (P0.05). Conclusion Needling the Eight Confluent Points plus Huo Xue Rong Luo granules is effective in treating spastic paralysis after cerebral infarction, which is plausibly associated with the up-regulation of inhibitory neurotransmitters (GABA and Gly).

Clinical Observation of Acupuncture at the Eight Confluent Points for Perimenopausal Syndrome / 上海针灸杂志

Objective To evaluate the clinical efficacy of acupuncture at the eight confluent points in treating perimenopausal syndrome (PMS). Method Sixty PMS patients were randomized into an acupuncture group of 30 cases and a Western medication group of 30 cases. In the acupuncture group, bilateral Gongsun (SP4), Neiguan (PC6), Zulinqi (GB41), Waiguan (TE5), Lieque (LU7), Shenmai (BL62), Houxi (SI3), and Zhaohai (KI6) were selected, 30 min for each treatment, once a day, 10 d as a treatment course; the treatment was given 15-18 d after each menstruation cycle, while for the menopausal patients, the treatment could start anytime. The Western medication group was prescribed with Tibolone tablets, 2.5 mg per dose, once a day, 30 d as a course. The intervention lasted 3 months for both groups. The Kupperman Index, serum estradiol (E2), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were observed before and after treatment, and the statistical results were then analyzed. Result Serum E2, FSH, and LH were significantly changed after intervention in both groups (P<0.05), and the increase of serum E2 in the acupuncture group was more significant than that in the Western medication group (P<0.05). The Kupperman score decreased significantly in both groups after intervention (P<0.05), and the improvements of symptoms in the acupuncture group were more significant than that in the Western medication group (P<0.05). The total effective rate in the acupuncture group (96.7%) was significantly higher than that in the Western medication group (83.3%). Conclusion Acupuncture at the eight confluent points is effective in treating PMS, and its therapeutic efficacy is more significant than that of the Western medication.

Relações customizadas e o ideário de amor na contemporaneidade / Customized relations and the ideal of love in the contemporaneity / Relaciones personalizadas y la ideología del amor en contemporaneidade

A regra pós-moderna sugere ausência de discursos e práticas normatizadores, apontando ser possível a homens e mulheres não somente reproduzir modelos sociais, mas inventar formas de parcerias amorosas, o que chamamos de customizar as relações. Consideramos a diversidade das configurações conjugais coexistentes em nossa sociedade e a família moderna que permanece como modelo ideal para a maioria. A partir destas considerações, discutimos em que medida um casal homossexual feminino e um heterossexual das camadas médias de Belo Horizonte estariam repetindo valores mais próximos do modelo conjugal moderno e do ideário romântico, e/ou reinventando formas. Concluímos que a combinação dos ideais e valores assumidos pelos casais não só reflete a ideia de customização, pois cada casal assume um modo singular de se relacionar, como diz também de uma capacidade adaptativa aos nossos tempos...

The postmodern rule suggests absence of norms, practices and discourses pointing possible men and women not only reproduce social models, but invent ways of loving partnerships, what we call customizing relationships. We consider the diversity of coexisting conjugal settings in our society and the modern family that remains as ideal model for most. From these considerations, we discussed the extent to which a homosexual couple and a heterosexual Belo Horizonte medium layers were repeating values closer to the model of the modern romantic ideal marital, and/or reinventing ways. We discussed the extent to which couples would be repeating values closer to the model of the modern romantic ideal marital, and/or reinventing ways. We conclude that the combination of the ideals and values assumed by married couples not only reflects the idea of customization, because every couple takes a singular way to relate, as also an adaptive capacity to our time...

La regla postmodernista sugiere ausencia de normas, prácticas y discursos señalando posibilidades a hombres y mujeres no sólo reproducir modelos sociales, sino inventar formas de asociaciones amorosas, lo que llamamos relaciones "customizadas". Consideramos la diversidad de configuraciones conyugales coexistentes en nuestra sociedad y la familia moderna que permanece como modelo ideal para la mayoría. De estas consideraciones, hemos hablado de la medida en que una pareja homosexual y un heterosexual de capas medianas de Belo Horizonte estaban repitiendo valores cercano al modelo del ideal romántico moderno marital, o reinventar maneras. Hablamos de la medida en que las parejas sería ser repitiendo valores más cercano al modelo del ideal romántico moderno o reinventar formas. Concluimos que la combinación de ideales y valores asumidos por las parejas no sólo refleja la idea de personalización, porque cada pareja toma una forma singular de relacionarse, como también una capacidad de adaptación a nuestros tiempos...

Topical Tretinoin Treatment for Confluent and Reticulated Papillomatosis / 대한피부과학회지

BACKGROUND: Confluent and reticulated papillomatosis (CRP) is a rare cutaneous disorder, characterized by persistent, scaling brown papules, patches, and plaques located on the trunk, neck, axillae, and shoulders. Many different treatments with variable success have been attempted, and oral minocycline treatment is effective in most patients with CRP. There were a few case reports of CRP responding to topical retinoid, but no clinical studies on the efficacy of the topical retinoid treatment for CRP have been reported. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of the topical tretinoin treatment for CRP. METHODS: A retrospective study was performed based on the medical records and clinical photographs of patients with CRP treated with 0.025% tretinoin cream. RESULTS: Nine patients (4 men and 5 women) were enrolled in the study. The mean age of the patients was 17.4 (11~34) years and the mean age at onset of CRP was 15.1 (3~33) years. The duration of disease varied from 1 month to 7 years. Six of the nine patients showed complete remission, and CRP lesions improved markedly after averagely 6.2 weeks from the beginning of the topical tretinoin treatment. The treatment response was better in patients without itch than in patients with itch (p=0.048). Adverse effects were detected in 3 patients, and were mild irritant contact dermatitis to the topical tretinoin. CONCLUSION: We think that topical 0.025% tretinoin treatment is an effective and safe treatment modality for CRP and this treatment can be an alternative or additional modality to the systemic treatment.

Confluent and Reticulated Papillomatosis without Papillomatosis / 대한피부과학회지

Confluent and reticulated papillomatosis (CRP) was first described as a relatively rare dermatosis. CRP is characterized by slightly hyperkeratotic pigmented papules that are confluent in the center and reticulated at the periphery, located on the neck, abdomen, intermammary, and interscapular regions. Histopathologically, lesions typically reveal orthohyperkeratosis, papillomatosis, and focal acanthosis. A 20-year-old man presented with a 2-year history of slightly pruritic lesions on the chest, abdomen, back, and upper extremities. The lesions were brownish papules and plaques in a reticulated and coalescing pattern. Histologically, a basket-weave pattern of orthohyperkeratosis and mild acanthosis were seen. However, there was no significant papillomatosis, even in multiple sections. Periodic acid Schiff stain was negative for fungi. The patient was treated with doxycycline, 200 mg daily, for 4 weeks. The lesions completely resolved and did not recur during 12 months of follow-up. We report a rare case of CRP without papillomatosis.

The gamma-Weibull distribution revisited

The five parameter gamma-Weibull distribution has been introduced by Leipnik and Pearce (2004). Nadarajah and Kotz (2007) have simplified it into four parameter form, using hypergeometric functions in some special cases. We show that the probability distribution function, all moments of positive order and the characteristic function of gamma-Weibull distribution of a random variable can be explicitely expressed in terms of the incomplete confluent Fox-Wright Psi-function, which is recently introduced by Srivastava and Pogány (2007). In the same time, we generalize certain results by Nadarajah and Kotz that follow as special cases of our findings.

A distribuição gamma-Weibull a cinco parâmetros foi introduzida for Leipnik e Pearce (2004). Nadarajah e Kotz (2007) a simplificaram para uma forma a quatro parâmetros usando funções hipergeométricas em alguns casos especiais. Nós mostramos que a função de distribuição cumulativa, todos os momentos de ordem positiva e a função característica da distribuição gamma-Weibull de uma variável randômica pode ser explicitamente expressa em termos da função-Psi de Fox-Wright confluente incompleta, recentemente introduzida por Srivastava and Pogány (2007). Ao mesmo tempo, generalizamos certos resultados de Nadarajah e Kotz que decorrem como casos especiais de nossos achados.

Papilomatose confluente e reticulada de Gougerot Carteaud: relato de caso / Confluent and reticulate papillomatosis of Gougerot-Carteaud: case report

Objetivo: descrever a evolução, as manifestações clínicas, o diagnóstico e o tratamento de um caso de Papilomatose Confluente e Reticulada de Gougerot-Carteaud, uma genodermatose da ceratinização, raramente descrita. Relato de caso: homem de 28 anos, com numerosas lesões papulosas, hipercrômicas, principalmente em região intermamária, que se tornaram confluentes, acometendo a região torácica anterior, região dorsal e cervical. O diagnóstico baseou-se nos dados clínicos e exame histopatológico;iniciou-se o tratamento com Azitromicina 500 mg, uma vez ao dia por três dias consecutivos e intervalo de sete dias. Após seis esquemas desta droga o paciente evoluiu satisfatoriamente.

Objective: report a case of confluent and reticulate papillomatosis of Gougerot-Carteaud, a rare cutaneous disorder characterized by confluent, flat, brown papules. Report of the case: a 28 year-old man presented flat brown papules on the intermammary region, which coalesced to form diffuse large plaques spread out the breast, neck and back regions. The diagnosis was made from clinical and histological findings. The pacient was treated with oral azythromycin. Final considerations: the lesions improved after six courses of treatment, being azythromycin an effective alternative treatment to this dermatosis.